How do clinicals work?

Lisa CCU RN, RN · Dec 10, 2006

I am starting clinicals in a couple weeks:lol2: -woohoo!! Anyways, how do they work? Do you go around in groups observing? Or does each student get assigned to a nurse to follow around? Do you go through all kinds of specialties? Do you get to observe a surgery? Sorry so many questions! I'm excited!!:)--I'm sure it varies between colleges, but just a general idea would be awesome THanks!

This is how mine, and generally most, clincals work.

The night before, you get assigned a patient and you go home and research the medical diagnoses that patient has. Then you come up with your nursing diagnoses and construct a careplan. You also will probably write down all the information pertinent to your patient's meds.

You get to clinical the next day and check in with your clinical instructor and sometimes have a preconference, then you head to the floor and get report form your nurse or you may just listen to them give report to the oncoming nurse.

You go introduce yourself to your patient and take vitals. You could follow with AM care, which is bathing, bed change etc or you may wait till aftr breakfast.

You should at this time check to see if everything in the patient's environment is safe ( no water spilled on floor, trash picked up, IV fluids running at right rate, see if patient is in need of anything).

You probably saw what time your patient had meds the night before, but now is a good time to see if new orders are on the chart or if new meds have been added. Then you get out any meds and go find your CI to check the dosages and then you do the five rights etc and give them.

A lot of things are progressively added per semester. For example, we only learned injections, topical, per rectum, PO meds first semester, but not IV stuff, so I really didn't check those on the patient at first. Our CI pointed them out to us though, so I started checking just so I could learn them.

We learned new skills second semester that we hadn't learned first, so we responsible to start doing whatever we were taught in skills lab.

Anyway, second semester, we did more care, minus giving baths, because we went up to two patients then three by the end and we did total care and charted on the patient and everything, whereas in foundations we were not allowed to chart and we had limited things we could do, but we generally took care of the patient ourselves with help from CI.

I hope my rambling gave you some kind of idea of what to expect.

Good Luck.

RN BSN 2009 · Dec 10, 2006

Our first semester of 1st year, our clinicals were at a LTC facility and we were assigned 1 patient each day (or 2 towards the end of the semester.) We assisted them with their ADL's, performed physical exams, took vitals, health histories, and we did lists of NANDA diagnoses for them. Very valuable experiences!

nurse4theplanet, RN · Dec 10, 2006

Similar Experience here.

Fundamentals (Sem 1)

Assigned a pt by CI and went to hospital night before to pour through the chart, writing down everything...all labs, orders, meds, diagnosis, etc. Then went home and had to write a patho on diagnosis, analyze any abnormal labs stating why they were abnormal for your patient, fill out drug sheet with all med info (trade name, generic name, dose, route, time, nursing responsibilities and side effects). Next day you got there really early to make sure your pt was not discharged or transferred or died overnight. Poured over the chart one more time writing down any new meds/therapies and adding them to your info. You have a short pre conference where CI grilled you about plan of care for that pt, what to expect, meds/labs, etc. Then you get report from your nurse and tell her what you were doing and how long you would be there: morning assessment, baths, linen change, feeding, give all po meds and injections (but not IVs), I&Os, charting, etc. Then give pt care. You have to have your nursing instructor present for anything like dressing changes, inserting a foley, etc. and the CI has to go over every med with you before you give it, and had to be there for shots. CI had to approve your charting before you could submit it. Then when you come off the floor you report off to your nurse and go to post conference where you talk about your day and go over stuff that you experienced that related to the lecture topics. Then you go home to write a very long care plan that includes actual pt outcomes based on your interventions that day during clinical.

From there it just gets more complicated. You learn more skills and begin to perform more nursing duties/take on more patients. Once that occurs you are allowed to delegate to the CNA. In OB/PEDs we could not do as much as we had done with adults because of facility policy. Psych was interesting, we could not wear uniforms...only street clothes. Advanced Med Surg was cool, we worked in an ICU step down. Throughout the whole process I got to rotate to the OR, ER, Trauma ICU, Burn Unit, ICU, Dialysis, Home Health, Health Department, and see a C-Sec delivery and tour NICU.

flygirls2, BSN · Dec 10, 2006

Wow, thanks for so much information everyone!! It soundsinteresting to me...why do so many people hate them?

nurse4theplanet, RN · Dec 10, 2006

Lots of paperwork

Lack of confidences

difficult CIs/Nurses

shock of finding out what 'real world' nursing environment is like, vs your idea of nursing before hitting the floor

having to get the CI before you do ANYTHING

horrible white NS uniforms that make you stand out (even though that is a good thing)

getting up at the crack of dawn, after you were up the night before analyzing pt info all night, knowing you have to go straight home and study for a test

things like that

flygirls2, BSN · Dec 10, 2006

Ah... I see . Well, hopefully I'll luck out in the CI department. But speaking of uniforms--I don't think anybody's could be worse than the one's required at my school. We have to wear horrible blue cargo pants and a see through white scrub top with a big and obvious school patch on the sleeve. And then we have to wear our student ID at all times as well. Yipeee:uhoh3:

locolorenzo22, BSN, RN · Dec 10, 2006

How about the solid see-through white zip tops, white vests, white lab coats, white scrub pants and white shoes? Plus, being a guy, I end up showing a lot of cleavage from the fact the zipper doesn't come up too high......

sissyboo · Dec 10, 2006

Wow. I was just browsing here. Everyones replies are great, however, overwhelming! I'm glad I'm getting to hear all this now before I actually start clinicals! Thanks!

flygirls2, BSN · Dec 10, 2006

How about the solid see-through white zip tops, white vests, white lab coats, white scrub pants and white shoes? Plus, being a guy, I end up showing a lot of cleavage from the fact the zipper doesn't come up too high......

Ha--Ok you win in the bad uniform competition.

locolorenzo22, BSN, RN · Dec 11, 2006

WHOO!!! What's the prize? (please not another uniform....although I'll take anything free I can get by this point!) How about a free A coupon?

sitesonRN · Dec 12, 2006

omg, it is so great to have an outlet/support like "allnurses". i have just been accepted into an adn program at my cc and start in jan. '07. i love the ? of "what are clinicals like", i was wondering about it myself; now i'm a little overwhelmed. however, i can't wait to jump in!

thanks to everyone for being so candid!:nuke:

good luck to everyone.